Rates of Retinal Nerve Fiber Layer Loss in Contralateral Eyes of Glaucoma Patients with Unilateral Progression by Conventional Methods

Liu, Ting; Tatham, Andrew J.; Gracitelli, Carolina P. B.; Zangwill, Linda M.; Weinreb, Robert N.; Medeiros, Felipe A.

doi:10.1016/j.ophtha.2015.07.027

Cited by 40 publications

(30 citation statements)

References 27 publications

(35 reference statements)

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“…This finding suggests that SD OCT might be detecting glaucomatous change in some eyes that were not detected by conventional SAP GPA™ analysis. This is in agreement with a previous study by Liu et al 37 showing that SD OCT detects progression in a large number of the contralateral eyes of glaucoma patients that show unilateral progression by SAP GPA™. However, it should be noted that it is not possible to exclude the possibility that RNFL loss was age-related in some of these eyes.…”

Section: Discussionsupporting

confidence: 93%

Association between Intraocular Pressure and Rates of Retinal Nerve Fiber Layer Loss Measured by Optical Coherence Tomography

et al. 2016

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Purpose To evaluate the relationship between intraocular pressure (IOP) and rates of retinal nerve fiber layer (RNFL) thickness change over time measured by spectral-domain (SD) optical coherence tomography (OCT). Design Observational cohort study. Participants The study involved 547 eyes of 339 patients followed for an average period of 3.9 ± 0.9 years. Three hundred and eight (56.3%) had a diagnosis of glaucoma and 239 (43.7%) were considered glaucoma suspects. Methods All eyes underwent imaging using the Spectralis® SD OCT (Heidelberg Engineering GmbH, Heidelberg, Germany), along with IOP measurements and standard automated perimetry (SAP). Glaucoma progression was defined as a result of “Likely Progression” from the Guided Progression Analysis™ software for SAP. Linear mixed models were used to investigate the relationship between average IOP during follow-up and rates of RNFL thickness change, while taking into account potential confounding factors, such as age, race, corneal thickness, and baseline disease severity. Main Outcome Measures The association between IOP and rates of global and sectorial RNFL thickness loss measured by SD OCT. Results Forty-six eyes (8.4%) showed progression on SAP during follow-up. Rates of global RNFL thickness change in eyes that progressed by SAP were faster than in those that did not progress (−1.02 µm/year versus −0.61 µm/year, respectively; P = 0.002). For progressing eyes, each 1 mmHg higher average IOP during follow-up was associated with an additional average loss of 0.20 µm/year [confidence interval (CI): 0.08 to 0.31 µm/year; P < 0.001] of global RNFL thickness versus only 0.04 µm/year (CI: 0.01 to 0.07 µm/year; P = 0.015) for non-progressing eyes. The largest associations between IOP and rates of RNFL change were seen for measurements from the temporal superior and temporal inferior sectors, whereas the smallest association was seen for measurements from the nasal sector. Conclusions Higher levels of IOP during follow-up were associated with faster rates of RNFL loss over time measured by SD OCT. These findings support the use of SD OCT RNFL thickness measurements as biomarkers for the evaluation of the efficacy of IOP-lowering therapies to slow down the rate of disease progression.

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Section: Discussionsupporting

confidence: 93%

Association between Intraocular Pressure and Rates of Retinal Nerve Fiber Layer Loss Measured by Optical Coherence Tomography

et al. 2016

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“…Miki et al 17 showed that the mean rate of global RNFL thinning was −2.02 μm/year in glaucoma suspect eyes that developed VFD and −0.82 μm/year in glaucoma suspect eyes that did not develop VFD. Liu et al 18 reported that mean rate of global RNFL thinning in eyes of glaucoma patients with unilateral progression was −0.89 μm/year and that in normal control eyes was −0.71 μm/year. In the current study, the mean rate of global RNFL thinning in eyes before DH was between −0.81 and −1.28 μm/year.…”

Section: Discussionmentioning

confidence: 99%

“…Linear mixed effects modeling was used to estimate the rates of change of global or local RNFL thinning, to account for repeated measurements over time and correlations between the two eyes of an individual. 17, 18, 22 A set of mixed-effects models were fit with RNFLT as the response, time as a fixed effect and random intercept and slope for each eye nested within each patient. The random slope values calculated using mixed effects modeling were compared with paired t -test between before and after DHs.…”

Section: Methodsmentioning

confidence: 99%

“…16–18 Longitudinal reports have evaluated glaucoma progression retrospectively after DH using time-domain (TD-) OCT or SD-OCT, but not before DH. 7–9 It has been observed that the progressive RNFL thinning after DH was associated with the location of DH compared to the respective contralateral quadrants or the contralateral eyes without DH.…”

Section: Introductionmentioning

confidence: 99%

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Rates of Local Retinal Nerve Fiber Layer Thinning before and after Disc Hemorrhage in Glaucoma

et al. 2017

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Purpose To investigate longitudinal temporal and spatial associations between disc hemorrhage (DH) and rates of local retinal nerve fiber layer (RNFL) thinning before and after DHs. Design Longitudinal observational cohort study. Participants Forty eyes of 37 participants (23 with glaucoma and 17 with suspect glaucoma at baseline) with DH episodes during follow-up from the Diagnostic Innovations in Glaucoma Study and the African Descent and Glaucoma Evaluation Study. Methods All subjects underwent optic disc photography annually and spectral-domain optical coherence tomography (OCT) RNFL thickness measurements every 6 months. The rates of RNFL thinning were calculated using multivariate linear mixed-effects models before and after DH. Main Outcome Measures Rates of global and local RNFL thinning. Results Thirty-six eyes of 33 participants with inferior or superior DHs were analyzed. The rates of RNFL thinning were significantly faster in DH quadrants than non-DH quadrants after DH (−2.25 and −0.69 μm/year, P < 0.001). In the 18 eyes with intensified treatment after DH, the mean rate of RNFL thinning significantly slowed after treatment compared to before treatment in the non-DH quadrants (−2.89 and −0.31μm/year, P < 0.001), but not in the DH quadrants (−2.64 and −2.12 μm/year, P = 0.19). In 18 eyes with unchanged treatment, the rate of RNFL thinning in DH quadrant was much faster after DH than before DH (P = 0.008). Moreover, compared to eyes without a treatment change, intensification of glaucoma treatment after DH significantly reduced the global, non-DH quadrants and DH quadrant rates of RNFL thinning after DH compared to before DH (global, P = 0.004; non-DH quadrant, P < 0.001; DH quadrant, P = 0.005). In the multiple linear regression analysis, treatment intensification (β, 1.007; P = 0.005), visual field MD (β, 0.066; P = 0.049), and difference in IOP before and after DH (β, −0.176; P = 0.034) were associated significantly with the difference of global RNFL slope values before and after DH. Conclusions Although there is a worsening of the rate of RNFL thinning in a DH quadrant after DH, glaucoma treatment intensification may have a beneficial effect in reducing this rate of thinning.

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“…Both progressing and stable eyes, by all criteria, showed significant RNFL thickness decreases from the baseline results in our study. Liu et al 26 reported that RNFL thicknesses decreased significantly even in eyes showing no progression, when estimated by conventional methods using both GPA of the VF test and stereo disc photography. Although the rate of RNFL decay of the study of Liu et al 26 (between − 0.71 ± 0.09 and − 1.0 ± 0.20 μm per year) was less than that of our results (−1.83 ± 3.22 and − 2.87 ± 3.86 μm per year in stable eyes using AMAF and GPA criteria, respectively), the use of different devices (Stratus vs Cirrus) and decaycalculating algorithms may have influenced the results.…”

Section: Discussionmentioning

confidence: 99%

Developing new automated alternation flicker using optic disc photography for the detection of glaucoma progression

Ahn

et al. 2016

Eye

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Purpose To evaluate a progression-detecting algorithm for a new automated matched alternation flicker (AMAF) in glaucoma patients. Methods Open-angle glaucoma patients with a baseline mean deviation of visual field (VF) test4 − 6 dB were included in this longitudinal and retrospective study. Functional progression was detected by two VF progression criteria and structural progression by both AMAF and conventional comparison methods using optic disc and retinal nerve fiber layer (RNFL) photography. Progression-detecting performances of AMAF and the conventional method were evaluated by an agreement between functional and structural progression criteria. RNFL thickness changes measured by optical coherence tomography (OCT) were compared between progressing and stable eyes determined by each method. Results Among 103 eyes, 47 (45.6%), 21 (20.4%), and 32 (31.1%) eyes were evaluated as glaucoma progression using AMAF, the conventional method, and guided progression analysis (GPA) of the VF test, respectively. The AMAF showed better agreement than the conventional method, using GPA of the VF test (κ = 0.337; Po0.001 and κ = 0.124; P = 0.191, respectively). The rates of RNFL thickness decay using OCT were significantly different between the progressing and stable eyes when progression was determined by AMAF (−3.49 ± 2.86 μm per year vs − 1.83 ± 3.22 μm per year; P = 0.007) but not by the conventional method (−3.24 ± 2.42 μm per year vs − 2.42 ± 3.33 μm per year; P = 0.290). Conclusions The AMAF was better than the conventional comparison method in discriminating structural changes during glaucoma progression, and showed a moderate agreement with functional progression criteria.

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Rates of Retinal Nerve Fiber Layer Loss in Contralateral Eyes of Glaucoma Patients with Unilateral Progression by Conventional Methods

Cited by 40 publications

References 27 publications

Association between Intraocular Pressure and Rates of Retinal Nerve Fiber Layer Loss Measured by Optical Coherence Tomography

Association between Intraocular Pressure and Rates of Retinal Nerve Fiber Layer Loss Measured by Optical Coherence Tomography

Rates of Local Retinal Nerve Fiber Layer Thinning before and after Disc Hemorrhage in Glaucoma

Developing new automated alternation flicker using optic disc photography for the detection of glaucoma progression

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